Could someone tell me the best way to get rid of acne scars on my chin and my cheeks?
How to Get Rid of Acne Scars?
Doctor Answers (21)
Rid of acne scarring
Acne scars can be a very troubling problem. Even though the acne breakouts may be controlled or have long since stopped, the scarring remains for a lifetime.
Treatment for acne can be as troublesome as the disease itself. Usually, successful treatment requires a team approach with a dermatologist and a cosmetic surgeon.
First, attention must be turned to stopping any outbreaks, then repair of the scarring. If outbreaks continue, scarring is likely to continue, and any treatments aimed at treating scarring would be futile. There are many options for treatment of acne today depending on the severity of outbreaks. These are beyond the scope of this article, except to say that treatment for the underlying disease process is a must. Once the outbreaks are well controlled, attention can be turned toward erasing the lasting marks on the face.
Of note, acne is not only a disease of adolescence. Adult onset acne is not completely uncommon and is seen in women who are pregnant – often with more severe scarring. Treatment options for acne scars depend on the severity of the scarring and the skin type of the person wishing repair.
In people with darker skin, Fitzpatrick Types V, VI; options are limited because of concern for pigment irregularities after treatment. For lighter skinned individuals, treatments range from simple facial exfoliation to deep chemical or laser peels to surgical intervention.
For light scarring after acne, attention is placed on skin resurfacing. By taking off the outer layers of skin and stimulating collagen synthesis with new skin formation, acne scars can be reduced. This is best simulated by placing a finger on either side of an area of scarring and lightly pulling. If the scars fade, this can be a good option for resurfacing.
For deeper scars, a deep chemical peel, ablative laser (CO2 or erbium) resurfacing, or dermabrasion/dermasanding may be necessary. For deeper scars, deeper solutions are necessary. Again, several options exist.
- Deeper scars can be surgically excised with the larger acne scar replaced with a surgically placed small line. This can later be refined with other rejuvenation techniques.
- Punch grafting affords a simple method for treating multiple scars. A circular punch is used to create an incision around an acne scar. The scar is then allowed to heal and the resulting skin irregularity is smoothed.
- Subcision involves releasing the tethering attachments underneath the scar and then filling the space with either a temporary or permanent filler to prevent the scar from reforming when it heals. With the advent of new temporary artificial fillers such as hyaluronic acid, this is a good option for larger depressed scars.
Whatever the treatment option, it is important to consult a physician with a large arsenal of treatment options – if a physician only sells a cheeseburger, then you get sold a cheeseburger, even if you need a bacon burger. It is also important to remember that just as acne scars did not form overnight, treatment can sometimes take months to get the desired result. Once you find an experienced physician and decide on a treatment option, remember that it’s a long road but one that is usually worth the wait.
Treating acne scars
Acne scars can be a devastating condition, and they have been notoriously difficult to treat. As noted by other physicians, they are almost impossible to remove completely, but we have many options to make the appearance of the scars much better.
There are different types of scars: some are shallow and gradual, some are deep - "ice-pick" scars - some are pigmented. Usually, it is the depth differential between the scar and surrounding skin that creates a light-shadow interface, and makes them prominent.
Most patients have a combination of different types, and are usually best treated by combination therapy. It can be a fairly long process for the patient, and may require patience on the part of both the patient and the physician.
Depending on type of the scar, our options are:
- Small shallow scars - usually can be addressed by a filler injection
- Deep ice-pick scars, especially large ones - need to be excised and meticulously reapproximated first, usually with subsequent dermabrasion or laser resurfacing.
- Dermabrasion has been a gold standard for treating extensive multiple scars. It is being gradually replaced by fractionated CO2 laser resurfacing. Among these, Deep FX is a promising new therapy for these patients. Sometimes several laser treatments are required, and occasionally dermabrasion followed by laser therapy is beneficial.
It is important to see a physician who has experience in treating these patients and who can offer you all of these options and recommend the right course of therapy.
How to get rid of acne scars
Acne scars can cause red or brown discoloration and uneven skin contour. Usually multiple types of treatments are needed for maximum improvement. Patience is key since the full effect is often not seen for several months.
Skin discoloration and texture can be improved with topical treatments like hydroquinone and Retin-A, but for deeper scars and more significant discoloration, other techniques are needed.
Small, deep acne scars can be treated with surgical excision, which will ideally trade a depressed and discolored scar for a thin, flat scar.This is often followed by other resurfacing techniques like laser, chemical peel or dermabrasion to further smooth the skin and minimize scarring.
Other techniques to improve large or numerous scars involve resurfacing the skin by intentionally traumatizing it in order to stimulate collagen production. This thickens the skin and shrinks the surface area of the scar, and color may be improved as well. The Cross technique uses a very concentrated TCA peel. There are multiple types of laser as well, and the best choice depends on the degree of improvement needed as well as your skin color. Unfortunately options are limited for patients with dark skin due to an increased risk of skin discoloration.
Risks for all these techniques include temporary or permanent lightening or darkening of treated skin, crusting, scabbing, persistent or new scarring, reactivation of cold sores, infection, redness, acne flares, and milia formation.
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Treatment options for acne scars
There are many options for getting rid of acne scars including laser treatments. Depending on the type of scars you have, you may evaluate several or all of the following treatments:
- FULL CO2 laser resurfacing (very effective, long downtimes and high expense)
- Erbium Laser Resurfacing (Effective, several treatments and some downtime required)
- Fractional CO2 & Other (Effective, marginally less downtime than Erbium)
- Non-ablative laser treatments (less effective, more3 treatments and no downtime)
- Punch excision (effective for deep ice pick scars)
- Dermabrasion (effective for many scars, difficult recovery and long downtime)
- Subcision (effective for certain types of fibrous scars)
The bottom line is that the type of treatment depends on the type of scars and you should attend several consultations to get different ideas about your options. The cost, potential outcome and downtime are important factors in choosing the method. Try to find specialists in each of these procedures as no one physician will perform them all.
Best treatment for acne scars
First you must realize that not all scars are created equal. The best treatment depends on what type of scarring we are talking about!
I see a lot of DARK SPOTS in my practice. These can be treated with a combination of skin lightening products, attention to sunscreen, and microdermabrasion and or chemical peeling (if the acne is still very active). Also, it is foolish to concentrate on the scarring if the acne is not yet under good control. Its sort of like changing the carpeting in your house but your roof is still leaking.
Getting rid of acne scars
There are generally three viable alternatives that we utilize on a regular basis:
- Erbium Laser which generally works with one treatment, but can be repeated if desired.
- Fraxel Laser which generally provides some improvement after 5 or 6 treatments.
- Injectables to fill the acne scars. This provides temporary but quick improvement of acne scars.
With any of these alternatives, you should find an experienced practitioner who is well trained.
Improving acne scars
While there is no way to make one’s skin that of a porcelain doll, acne scars can be improved. This usually requires a number of treatments with the CoolTouch, Smooth Beam, Affirm, Active FX or Fraxel lasers, which can minimize their appearance.
We often combine lasers with subcision and/or injection of fillers.
A combination approach works best for acne scars.
Different types of acne scars will need different treatments. Most approaches will make at least some level of improvement on all scars. It is important to have realistic expectations about what results are possible before beginning treatment. Resurfacing procedures like Fraxel, microdermabrasion and chemical peels can all give you smoother skin as well as minimize the discoloration left behind by more recent blemishes. Usually a combination of resurfacing treatments is the best approach. And remember, before addressing the scars, be sure to clear up any active break-outs.
Fraxel For Acne Scars
Thank you for your question. At my practice, I have gotten excellent results for scarring with Fraxel. This treatment eliminates irregular skin discoloration, and stimulates new collagen production, tightening the skin without prolonged recovery. After a series of 2 to 4 Fraxel treatments, the cumulative cosmetic improvement is near more aggressive lasers, but unlike more aggressive lasers, redness and swelling eliminated within 2 to 4 days after each treatment. Fraxel is outstanding for fine wrinkles, mild skin laxity, irregular pigmentation, acne scars, surgical scars, enlarged pores, stretch marks, age spots and Rosacea. It can be used safely on the face, neck, hands, arms, and chest.
There are several options to treat acne scars.
There are several options available to treat acne scars - the choice of treatment will depend on the nature of the scar. While some superficial scars respond to chemical peels, deeper scars require some form of dermatologic surgery or LASERs. Not all scars respond alike, and a combination/ sequence of treatments is often required.
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